Individual
KELLY ANN BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78 WOODBINE LN, DANVILLE, PA 17821-8020
(570) 275-5240
Mailing address
811 HILLTOP RD, CINNAMINSON, NJ 08077-3321
(856) 220-5653
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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